Plans to start comprehensive registry for corneal transplant

With more private hospitals taking up corneal transplantation, it has become necessary for the Cadaver Transplant Programme of Rajiv Gandhi Government General Hospital to come up with a cornea registry.

The need for such a database was highlighted at a recent meeting in which eye hospitals and eye banks participated. A comprehensive registry will not only help health professionals and the government understand the process of harvest, but also give a good indication of the success rate of corneal transplantation. It would also help see if claims of private hospitals using advanced techniques for transplantation actually translate into better results.

Cornea is the transparent structure in the eye, which in case of injury or insult turns opaque, resulting in loss of sight. As corneas do not require blood supply, the need for tissue matching does not arise. However, there is no data on the success rate of eye transplantations or subsequent follow up though the State Blindness Control Society collects details of corneas collected and utilised.

Corneas can be donated at any age but their suitability must be assessed before it is transplanted. Doctors follow a protocol and harvested corneas are rejected either because they are infected, retrieved late or are damaged. This is the reason why only around 50 per cent of the corneas that are harvested are of quality that can be transplanted, says Mohan Rajan of Rajan Eye Care Hospital, which does one transplant a day.

Rama Rajagopal, Deputy Director, Cornea Department, Sankara Nethralaya says, “Harvested corneas are subjected to qualitative tests to assess their suitability to avoid transmitting an infection from the donor to the recipient.”

Amar Agarwal, who performs two corneal transplants every day, says that though technology has advanced “the bottom line in transplantation is that corneas should be harvested within six hours of a person's death and the surgery for transplantation done immediately.”

While each hospital is able to provide data about the number of transplantations, there is little information about the number of persons who have recovered sight and the follow-up done by hospitals, says J. Amalorpavanathan, State transplant coordinator.